Cancer is costly in a number of ways, which makes it imperative that employers start asking if their employees are protected against the obvious – and less obvious – financial impacts of cancer.
Annually, a hundred million people globally face poverty because of healthcare expenses. This is according to a recent forum hosted by the World Health Organization (WHO) and the South African government on the cost of medicine. A study in the US tracked the finances of 9,5 million people older than 50 at two and four years after diagnosis. A staggering 42,4% had depleted their life’s assets by year two. By year four, financial insolvency reached 38,2%. It’s not just medicine – although oncology drugs reaped US$123,8 billion in sales in 2018 – it’s the lifestyle costs of cancer as well, which is why it’s imperative that employers start asking if their employees are protected against the obvious – and less obvious – financial impacts of cancer.
Last year, the majority of Sanlam’s disability claims (25%) were for cancer. Additionally, cancer and tumours accounted for 61% of severe illness claims. Of severe illness claims for women, 80% were for cancer, 31% of which were for breast cancer and 6% for skin cancer. Of men’s claims, 45% were for cancer, with 33% of these for prostate cancer. But regardless of the type of cancer and who is affected, one thing is for sure: cancer is costly in myriad ways.
Karen Bongers, Product Development Actuary at Sanlam Individual Life, says employers can play a critical role in raising awareness among employees of the costs of cancer, including lifestyle expenses. ‘While many employers provide medical aid, and some insurance cover, it’s also important to help make people aware of the full picture in terms of costs. In the event of cancer, having severe illness and similar policies in place could make a dramatic difference financially. It’s really important that individuals understand all the additional, non-treatment-related expenses and how certain policies can help cover these.’
Karen mentions some of the most significant non-treatment-related expenses.
Petrol and transport costs
With yet more fuel hikes on the horizon in South Africa, this is a very real concern. Transport to and from doctors and treatment centres can add up, especially in more rural regions, where patients may need to travel further to receive care. Accommodation costs may also be incurred.
When patients are at home for extended periods of time due to sickness, inevitably costs like water, electricity and data are likely to increase, which can add up to an extra thousand or so each month.
Many patients seek alternative therapies, such as counselling and acupuncture.
Currently, a live-in caregiver earns around R54 000 per annum, according to PayScale. That’s about R4 500 per month. This can vary considerably depending on experience. St Luke’s Hospice in Kenilworth, Cape Town, provides free palliative care to patients and their families.
Another little-talked-about expense is home adjustments. Often homes need to be adapted to make patients more comfortable – for example, making sure a patient’s bedroom and bathroom are on the ground floor. Variations could range from grab bars in the shower to rebuilding a bedroom.
Often, patients lose weight or want gentle, looser, more comfortable clothes, so it’s wise to budget for new clothing, including hats, pyjamas and slippers.
It’s also good to budget for a consultation with a dietitian regarding the best meal plan to follow, especially when undergoing chemotherapy, which can cause nausea and a lack of appetite. Then, food expenses might increase depending on the suggested diet. In addition, patients who feel too unwell to make meals for themselves may opt for having meals delivered – a service that incurs even more costs.
According to PriceCheck, human hair wigs can cost anything from R400 to R5 000. However, some salons give discounts to cancer patients and the Cancer Association of SA (CANSA) distributes wigs from donated hair when these are available.
Out-of-pocket medical expenses
There’s been a lot of conversation around the radical cost of cancer treatments recently. There are many reasons why medicine is so expensive in South Africa. Although cancer is a Prescribed Minimum Benefit (PMB) for medical aid schemes, there’s often a sizeable shortfall, which is where gap cover may play an important role. However, according to legislation, gap cover is capped at an overall annual limit of R157 000 per person. Although severe illness cover pays per health event and not per treatment, it can help cover out-of-pocket medical expenses.
It’s vital that employers facilitate talks and create awareness to ensure employees are clear on the cover provided through the company – for example, an employee needs to be aware if the company provides group risk cover and whether such cover includes cover for cancer. If not, an employee could always take out cover in their personal capacity. Sanlam Life offers a very comprehensive cancer-only benefit, specifically designed to offer cover where it’s needed.
Karen concludes, ‘Employers have the opportunity to potentially change their employees’ lives by having essential conversations around how people can protect themselves when the worst kinds of curveballs like cancer happen.’